Korean Journal of Nephrology 2007;26(3):348-352.
Hyperkalemic Paralysis with Unexplained Causes : A Case Report
Hyeong-Do Cho, M.D., Joo-Hark Yi, M.D., Young-Hoon Kim, M.D. Sang-Woong Han, M.D. and Ho-Jung Kim, M.D.
Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
Hyperkalemic Paralysis with Unexplained Causes : A Case Report
Hyeong-Do Cho, M.D., Joo-Hark Yi, M.D., Young-Hoon Kim, M.D. Sang-Woong Han, M.D. and Ho-Jung Kim, M.D.
Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
Abstract
Hyperkalemic paralysis can be either a rare hereditary form due to channelopathies or common secondary ones related to various medications interfering potassium homeostasis upon underlying renal impairment. We hereby describe a 36-yr-old woman presented with the first episode of sudden hyperkalemic paralysis due to severe hyperkalemia, 8.6 mEq/L, but which resolved quickly to the normalization of serum potassium level by the conventional remedies, including calcium gluconate, insulin and glucose, and potassium-binding resin for severe hyperkalemia over 10 hours and remained normokalemic without any medications or dialysis for the next 10 days in hospital. The discernible history of medications or potassium-rich food intakes was denied on repeated interrogation. Other diagnostic work-ups to investigate its etiologies responsible for this acute hyperkalemic paralysis including neurological examination, serial biochemical data, and endocrinologic diagnostic work-ups for underlying causes failed, but only revealed only a transient hyperkalemic episode with appropriate response of renal potassium excretion. Therefore, we report a puzzling case of hyperkalemia with unexplained causes in a young woman, though the evidences are in favor of acute intracellular potassium shift based on the short duration of reversible hyperkalemia with intact response of increased renal potassium excretion.
Key Words: Hyperkalemia, Paralysis, Potassium, Homeostasis
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